Hospital percutaneous coronary intervention appropriateness and in-hospital procedural outcomes: insights from the NCDR.

Circulation. Cardiovascular Quality and Outcomes
Steven M BradleyBrahmajee K Nallamothu

Abstract

Measurement of hospital quality has traditionally focused on processes of care and postprocedure outcomes. Appropriateness measures for percutaneous coronary intervention (PCI) assess quality as it relates to patient selection and the decision to perform PCI. The association between patient selection for PCI and processes of care and postprocedural outcomes is unknown. We included 203 531 patients undergoing nonacute (elective) PCI from 779 hospitals participating in the National Cardiovascular Data Registry (NCDR) CathPCI Registry between July 2009 and April 2011. We examined the association between a hospital's proportion of nonacute PCIs categorized as inappropriate by the 2009 Appropriate Use Criteria (AUC) for Coronary Revascularization and in-hospital mortality, bleeding complications, and use of optimal guideline-directed medical therapy at discharge (ie, aspirin, thienopyridines, and statins). When categorized as hospital tertiles, the range of inappropriate PCI was 0.0% to 8.1% in the lowest tertile, 8.1% to 15.2% in the middle tertile, and 15.2% to 58.6% in the highest tertile. Compared with lowest-tertile hospitals, mortality was not significantly different at middle-tertile (adjusted odds ratio [OR], 0.93; 95% confi...Continue Reading

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Citations

May 25, 2013·The American Journal of Emergency Medicine·Deborah B DiercksJames A de Lemos
Sep 23, 2014·JACC. Cardiovascular Interventions·Olivia Y HungH Vernon Anderson
Mar 2, 2013·Journal of the American College of Cardiology·David R HolmesMichael J Mack
Sep 24, 2013·Journal of the American College of Cardiology·Karen E Joynt
Jun 2, 2018·Circulation. Cardiovascular Quality and Outcomes·Daniel M AlyeshBrahmajee K Nallamothu
May 16, 2013·Circulation. Cardiovascular Quality and Outcomes·Manesh R Patel, Sunil V Rao
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Nov 12, 2019·Circulation. Cardiovascular Quality and Outcomes·Tharmegan TharmaratnamR Sacha Bhatia
Apr 10, 2013·PharmacoEconomics·Michael J SorichBrita Pekarsky
Jun 4, 2021·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Lloyd W KleinUNKNOWN AUC Workgroup of the ISLC Endorsed by the Interventional Section Leadership Council, American College of Cardiology

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